Post-Ozempic body: ‘When I stopped the medicine, I gained weight again. Sometimes I hate what I see in the mirror’ | Health

The architect and urban planner Larissa*, 33, has always recognized herself as a fat woman. Throughout her life, she dieted and exercised in an attempt to lose weight. The numbers on the scale only began to reduce significantly with the use of Ozempic. However, when she stopped taking the medication, she gained weight again and suffered a psychological impact.

“My obesity reached the point where I discovered high blood pressure at the age of 20 and needed medication because of it. In 2017, I started a dietary re-education process that made me lose 20 kilos in five months and was very satisfying for me. But then, mainly because of anxiety, I gained back a lot of the weight I had lost”, he says.

Larissa decided to look for a new cardiologist to find out how to reverse her hypertension. She explains that she knew that losing weight would be part of the process, but she did not imagine that the Ozempic prescription would come right at the beginning of the medical follow-up.

“Right away, he gave me the medicine and I wrinkled my nose. I had already taken sibutramine and it had a very bad effect on me, so I didn’t want medication. I tried other natural treatments and, after three months without the expected results, I accepted Ozempic. I knew what I was getting into, but I didn’t know what would happen when I left,” he recalls.

Larissa says that she was not directly pressured by the specialist to use the medicine, but the surroundings gave the feeling that the medicine would be the only effective solution for weight loss.

“He didn’t need to show me success stories, I saw them on his Instagram. He was a doctor with many patients and it was even difficult to get an appointment with him. People around me said that I was in good hands and that now, with the use of the medicine, it would work out”, he says.

Side Effects of Weight Loss

In addition to the psychological consequences, Larissa reports that she suffered from physical issues as well, such as an increase in acne at the beginning of treatment and significant hair loss. “Tuffs fall. I had so few strands of hair that I was a bridesmaid at my wedding and the hairdresser said I wouldn’t be able to do any hairstyle,” she says.

“All weight loss will cause hair loss, with medication or not, because weight loss reduces body protein. Furthermore, they can become more brittle”, explains the endocrinologist Maria Fernanda Barcamember of the Brazilian Society of Endocrinology and Metabology (SBEM).

The tachycardia mentioned by the architect is also something that can happen with the use of Ozempic. Barca, for example, avoids prescribing the medication to patients with anxiety and depression. Palpitation, which is a symptom of these psychological disorders, can be enhanced by the drug.

Ozempic is not a guarantee of rapid weight loss

The architect reports that in around two months using the semaglutide-based medicine she lost 14 kilos. “When I arrived to work out, the trainers didn’t recognize me,” she says.

According to the clinical doctor Fabrícia Jung, specialized in nutrition and obesity medicine, care must be taken when talking about how quickly you can lose weight. A nutritional re-education process needs to be done with caution.

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“Otherwise, the person will be hungry. The more weight you lose, the more the body tends to encourage you to eat to get back to your previous weight, which it perceives as normal. With Ozempic, there is an appetite inhibition. The person is not hungry when eating, which leads to a more sudden reduction in caloric intake and, therefore, weight loss can be faster”, explains the specialist.

The large weight loss in a short space of time, from the semaglutide medication, may be related to the fact that the medication is also acting on other mechanisms in the body, such as reducing insulin resistance. It is worth remembering that Ozempic’s main indication is for patients with type 2 diabetes.

“Initial weight loss is often also associated with fluid loss. In the first month, the tendency to lose weight is greater and then it reduces”, adds the specialist.

Jung clarifies, however, that rapid weight loss with Ozempic is something more sold by the media than scientifically proven behavior.

“In the semaglutide study, at a dose of 2.4 per week, weight loss was around 15 to 17% compared to the initial dose, over 17 months. We are talking about a person weighing 100 kilos, for example, who will lose around 15 kilos in a year and a half. That’s no small feat. It is enough to improve glycemic control and blood pressure values. But it is not always enough for the expectation and aesthetic pressure that the patient has to bear”, he reflects.

The psychological consequences of the accordion effect

Before starting treatment with the medication, Larissa began psychological counseling because she was overweight and could not make peace with her reflection in the mirror. When the medicine was introduced and the kilos started to reduce, the scenario changed for the architect.

“I started to love myself with this body that Ozempic gave me. It was very satisfying to go everywhere and have people talk about how much weight I had lost and how beautiful I looked. They were phrases I always hoped to hear,” she recalls.

The weight loss follow-up lasted around six months and, in addition to the medication prescription, Larissa received guidance regarding diet and physical exercise. Both factors are important for maintaining weight loss. During this period, the architect spent around 12 thousand reais on consultations and medicines.

“When I stopped taking Ozempic because it became too expensive and the consultation too, I was on my own. As much as I was aware that I needed to get good sleep, maintain physical activity and eat well, it wasn’t enough. In my head, only Ozempic could save me, give me that body,” she reports.

Larissa began to experience an internal struggle. She tried to save money to buy the medicine, but it seemed like she needed increasingly larger doses to maintain the weight she lost. However, this would not be possible because her financial resources were no longer sufficient.

Unable to financially maintain the medication and the new habits necessary to maintain weight loss, Larissa gained weight again. Two years after stopping Ozempic, she gained about 17 pounds.

“I would be a liar if I said that I love the way I am today and that I feel empowered. I don’t love and hate is too strong a word. But sometimes I hate what I see in the mirror,” she reflects.

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The psychologist Vanessa Tomasinispecialist in eating disorders at Ambulim – IPQ HC-FMUSP, explains that cases like Larissa’s, in which there is a large loss of weight in a short space of time, can be difficult to deal with psychologically.

“In terms of body image distortion, the person does not have time for the brain to adapt the map of the real body size, that is, to know exactly its new size. There is a risk that she will not realize that the weight loss has already been quite significant, using the medication always looking for a little more weight loss”, reflects the psychologist.

Accelerated weight loss can also be a trigger for the development of conditions such as bulimia and anorexia nervosa, as well as binge eating, as mentioned by the psychologist Teresa Mulleralso specializing in eating disorders.

“After rapid and significant weight loss, the individual may feel pressured to continue losing or maintain the lost weight at any cost, and may develop restrictive behaviors regarding food, as well as obsessions with eating, counting calories and intense physical exercise” , explains the specialist.

Larissa reports that the fear of gaining weight after stopping Ozempic caused her to refuse invitations to go out. “Or when I went out, I would just order sparkling water and lemon, small portions so as not to be anti-social, or salads,” she says. The architect still remembers that she used laxatives to avoid gaining weight.

Larissa was diagnosed with binge eating when she saw a psychiatrist and treatment with semaglutide-based medication could be a dangerous choice.

“As the patient has a greater feeling of satiety, this may cause her to temporarily reduce the amount of food ingested. But not because she is managing other strategies to avoid resorting directly to food, but because she has a feeling of being stuffed, of being stuffed”, explains Tomasini.

By not taking it out on food, compulsion may end up appearing in other types of behavior. The architect mentions, for example, that she started buying more and more clothes, mainly because her wardrobe went from size 38 after losing weight to size 48 when she gained weight again.

*The name has been changed at the request of the interviewee